Pilot Investigation of Behavioral Alternatives to Indoor Tanning

描述(由申请人提供)：35岁之前在室内晒黑会增加患黑色素瘤的风险，黑色素瘤是最致命的皮肤癌类型。尽管存在风险，25%-40%的年轻女性报告说在过去的一年里使用过。室内晒黑有两个原因：外表美观和减轻压力。行为经济学理论表明，减少不健康行为的有效方法是增加替代方案，以类似或更少的努力或成本提供类似的功能。日光浴(ST)是一种很有前途的IT替代方案，因为它可以在没有紫外线照射的情况下产生棕褐色。越来越多的证据表明，采用ST的室内晒黑者随后会减少它。9我们对海滩游客的试验显示，在ST干预后，日光浴减少了，但我们还没有在室内晒黑的人中测试这一点，对他们来说，晒黑的愿望是一个强烈的动机(比海滩游客更强烈)。1 ST面临的一个挑战是，它不是减压的来源，这是年轻女性在室内晒黑的另一个主要原因。瑜伽对减轻压力很有效，因此有可能成为IT的健康替代品。将ST和瑜伽结合起来，通过解决这两个关键的IT激励因素，可能会被证明是减少IT的有力组合。本研究的目的是确定向室内晒黑工提供免费的ST和瑜伽的可行性和短期效果，以努力“推动”他们从IT转向健康的替代品。选择健康的替代品(ST和瑜伽)是基于它们与IT产生的直接后果相似，但两者在IT期间都是不可能做到的(以避免增强)。免费使用健康的替代品为参与者提供了一个低风险的机会，尝试与他们的动机一致的新东西。体验替代品的增强性能可能会促进继续使用。我们将从女性室内晒黑的焦点小组开始，征求对ST和Hatha瑜伽的意见和障碍，并就拟议的干预程序提供反馈。在完善干预措施后，室内晒黑的女性(N=150)将被随机分成三种情况之一：晒黑、晒黑+瑜伽和对照。我们假设，与对照相比，无阳光条件将导致IT的更大减少，而Sinless+瑜伽将导致相对于单独的Sawine，IT的更大减少。将评估相对于I的健康替代品的成本、收益和可接受性。本研究将测试干预效果的调节变量(晒黑依赖、感觉寻求、身体形象、感知压力)和中介变量(瑜伽的减压效果、ST和瑜伽的可接受性)对信息技术的影响。干预后将进行重点小组，以评估干预措施的可接受性、促进者和障碍。我们还将对晒黑企业主进行关键的线人访谈，以评估他们的反应和意见，了解哪些类型的数据和/或新立法将迫使他们改变商业计划，转向健康的替代品。本研究的数据将被用来支持一项更大的试验，该试验测试与有效的基于印刷的干预相比，免费试用期的ST加瑜伽和不加瑜伽的短期和长期效果。 公共卫生相关性：紫外线暴露会增加患黑色素瘤的风险，特别是在室内晒黑的年轻女性中。室内日光浴报告称，晒黑是为了改善外表和减轻压力，而这些好处似乎超过了对健康的风险。本研究将确定激励室内晒黑的人参与健康的替代行为，以提高外表(晒黑)和减轻压力(瑜伽)是否会减少他们的室内晒黑。

DESCRIPTION (provided by applicant): Indoor tanning (IT) before the age of 35 increases risk for melanoma-the most fatal type of skin cancer. In spite of the risks, 25-40% of young women report use in the past year. Indoor tanners report two reasons for IT: physical appearance and stress reduction. Behavioral economic theory suggests that an effective way to decrease an unhealthy behavior is by increasing alternatives that serve a similar function with comparable or less effort or cost. Sunless tanning (ST) is a promising IT alternative because it produces a tan without UVR exposure. Mounting evidence suggests that indoor tanners who adopt ST subsequently reduce IT.9 Our trial of beach visitors showed reduced sunbathing following a ST intervention, but we have not tested this in indoor tanners, for whom the desire to be tan is a strong motivator (more so than beach visitors).1 One challenge to ST is that it is not a source of stress reduction, the other major reason young women tan indoors. Yoga is efficacious for stress reduction and so may have potential to be a healthy alternative to IT. Together ST and yoga, by addressing both key IT motivators, may prove a potent combination for reducing IT. The objective of the present study is to determine the feasibility and short-term efficacy of providing free ST and yoga to indoor tanners in an effort to "nudge" them to switch from IT to healthy alternatives. The healthy alternatives (ST and yoga) were chosen based on their having similar immediate consequences as IT, while both being impossible to do during IT (to avoid potentiation). Free access to healthy alternatives gives participants a low-risk opportunity to try something new that is consistent with their motivations. Experiencing the reinforcing properties of the alternatives could prime continued use. We will begin by conducting focus groups of female indoor tanners to solicit opinions about and barriers to ST and Hatha yoga and feedback on proposed intervention procedures. After refining the intervention, female indoor tanners (N=150) will be randomized to one of three conditions: Sunless Tanning, Sunless+Yoga, and Control. We hypothesize that the Sunless condition will lead to greater reductions in IT relative to Control, and Sunless+Yoga will lead to greater reductions in IT relative to Sunless alone. Costs, benefits, and acceptability of healthy alternatives relative to I will be assessed. Moderators (tanning dependency, sensation seeking, body image, perceived stress) and mediators (stress reduction effect of yoga, acceptability of ST and yoga) of the interventions effects on IT will be tested. Focus groups will be conducted following the intervention to evaluate acceptability, facilitators, and barriers to the interventions. We will alo conduct key informant interviews of tanning business owners to assess their reactions and opinions on what type of data and/or new legislation would compel them to change their business plan toward healthy alternatives. Data from the present study will be used to support a larger trial that tests the short- and long-term effects of free trial periods of ST with and withot yoga relative to an effective print-based intervention. PUBLIC HEALTH RELEVANCE: Ultraviolet radiation exposure heightens risk for melanoma, especially among young women who tan indoors. Indoor tanners report that they tan to improve their physical appearance and to reduce stress, and these benefits seem to outweigh the health risks. The present study will determine whether incentivizing indoor tanners' engagement in healthy alternative behaviors that enhance appearance (sunless tanning) and reduce stress (yoga) will decrease their indoor tanning.